Active NPI
Eric Yang, DO
- Pediatrics Physician
- Grand Forks Afb, ND
National Provider Identifier
1174975866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0102206254
- Practice address
- 1599 Jones Street
Grand Forks Afb, ND 58205 - Phone
- (701) 747-5547
- NPI assigned
- Jul 6, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0102206254 | VA | Primary |
Addresses
Primary practice location
1599 Jones Street
Grand Forks Afb, ND 58205
Mailing address
1599 Jones Street
Grand Forks Afb, ND 58205
Phone (701) 747-5547
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174975866 | Other | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102206254 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1174975866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1599 JONES STREET",
"city": "GRAND FORKS AFB",
"state": "ND",
"postal_code": "58205",
"telephone_number": "701-747-5547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1599 JONES STREET",
"city": "GRAND FORKS AFB",
"state": "ND",
"postal_code": "58205",
"telephone_number": "701-747-5547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANG",
"first_name": "ERIC",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-06",
"last_updated": "2022-09-08",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0102206254",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1174975866",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks Afb, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.